Thoracic spine surgery encompasses a range of surgical procedures targeting the mid-back region of the spine, specifically the twelve thoracic vertebrae (T1-T12) that extend from the base of the neck to the bottom of the rib cage. The thoracic spine is unique among spinal regions due to its attachment to the rib cage, which provides inherent stability but also limits mobility compared to the cervical (neck) and lumbar (lower back) regions. This anatomical configuration makes the thoracic spine less prone to degenerative disc disease but more vulnerable to specific conditions including spinal fractures from trauma or osteoporosis, spinal tumors, thoracic disc herniations, kyphotic deformities (excessive forward curvature), and spinal cord compression from various causes. Dr. Kumar provides comprehensive thoracic spine surgical care at Arthoscenter, addressing the full spectrum of thoracic pathology using both minimally invasive and traditional open surgical approaches. Common indications for thoracic spine surgery include vertebral compression fractures (often from osteoporosis or trauma), thoracic disc herniations causing myelopathy (spinal cord compression), spinal tumors (both primary bone tumors and metastatic lesions), thoracic spinal stenosis, kyphotic deformities (including Scheuermann's disease in adolescents), spinal infections (tuberculosis is particularly common in Bihar), and traumatic fractures with spinal instability. Unlike lumbar spine surgery which is relatively common, thoracic spine surgery is less frequently performed and requires specialized expertise due to the proximity of vital structures including the spinal cord, major blood vessels (aorta), heart, and lungs. Surgical approaches to the thoracic spine can be categorized as posterior (from the back), anterior (from the front through the chest cavity), or combined anteroposterior approaches. Posterior approaches are most common and involve laminectomy (removal of the lamina to decompress the spinal cord), transpedicular decompression for disc herniations, and posterior spinal fusion with instrumentation using pedicle screws and rods for stabilization. Anterior approaches require thoracotomy (opening the chest) or thoracoscopy (minimally invasive video-assisted chest surgery) and are indicated for certain tumor resections, anterior column reconstruction after trauma, and correction of severe kyphotic deformities. Dr. Kumar employs image guidance, intraoperative neuromonitoring, and microsurgical techniques to enhance safety and precision during these complex procedures. Thoracic disc herniations present unique surgical challenges because direct posterior approaches risk injuring the spinal cord. Dr. Kumar utilizes specialized techniques including transpedicular approaches (working through the pedicle bone), costotransversectomy (removing a portion of rib and transverse process for lateral access), and video-assisted thoracoscopic surgery (VATS) for anterior disc removal. For vertebral compression fractures, minimally invasive options include vertebroplasty and kyphoplasty, where bone cement is injected into the fractured vertebra to stabilize it and relieve pain. These procedures can often be performed as outpatient or short-stay procedures with rapid recovery. For unstable fractures or those with neurological compromise, open surgical stabilization with instrumentation is necessary. At Arthoscenter, our thoracic spine surgery outcomes have been excellent, with over 85% of patients experiencing significant pain relief and neurological improvement when indicated. Recovery varies widely depending on the procedure performed, ranging from days for minimally invasive vertebroplasty to months for major reconstructive surgery involving spinal fusion. We emphasize comprehensive pre-operative evaluation including MRI, CT scans, and sometimes specialized imaging such as myelography to precisely define pathology. Post-operative care includes early mobilization when safe, bracing for spinal stability during healing, physical therapy for strengthening and posture training, and treatment of underlying conditions such as osteoporosis to prevent future fractures. Our multidisciplinary approach ensures optimal outcomes for patients with these challenging thoracic spine conditions.